title: Total knee replacement with retention of both cruciate ligaments: a 22-year follow-up study.
abstract: We report on the long-term results of 163 bicruciate-retaining Hermes 2C total knee replacements in 130 patients at a mean follow-up of 22.4 years (20.3 to 23.5). Even when the anterior cruciate ligament had a partially degenerative appearance it was preserved as long as the knee had a normal anterior drawer and Lachman's test pre-operatively. The description and surgical technique of this minimally constrained prosthesis were published in 1983 and the ten-year clinical results in 1999. A total of 12% of the knees (20 of 163) in this study were revised because of wear of the polyethylene tibial insert. Excellent stability was achieved and the incidence of aseptic component loosening was 4.3% (seven of 163). The survival rate using revision for any reason as the endpoint was 82% (95% confidence interval 76.2 to 88.0). Although this series included a relatively small number of replacements, it demonstrated that the anterior cruciate ligament, even when partially degenerated at the time of TKR, remained functional and provided adequate stability at a long-term follow-up.
authors.affiliation: Centre Hospitalier de l'Université de Montréal, Orthopaedic Surgery Department, Hôpital Notre-Dame, 1560 rue Sherbrooke Est, local DR-1118-16, H2L 4M1, Montréal, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Sabouret
authors.forename: F
authors.initials: F
authors.lastname: Lavoie
authors.forename: J-M
authors.initials: JM
authors.lastname: Cloutier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000601:surgery*; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D016119:Posterior Cruciate Ligament / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000601:surgery; D012086:Reoperation / Q000706:statistics & numerical data*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Arthroplasty; Cruciate ligaments; Knee; Long-term follow-up; TKA; TKR